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Abstract Background COVID-19 significantly impacted physician assistant/associate (PA) education programs. Most programs transitioned didactic and clinical education from in-person to remote, and clinical training opportunities diminished. Graduates of accredited PA programs take the Physician Assistant National Certifying Examination (PANCE), a five-hour exam with 300 multiple-choice questions, and must attain or exceed the scaled passing score of 350 (range: 200–800). We examined first-time examinees’ trends in PANCE scores and passing rates three years prior to the pandemic and three years during. Methods We analyzed data (N = 59,459) from the National Commission on Certification of Physician Assistants. The two primary outcomes were PANCE scores and pass rates. The main exposure was the timeframe: three years pre-pandemic (2017–2019) and three years during the pandemic (2020–2022). The 2017–2018 scores were equated to the new passing standard implemented in 2019. Covariates included age, gender, years the PA program has been accredited, program region, and rural-urban setting. Analyses consisted of descriptive, bivariate, and multivariate statistics. Results The mean PANCE score and pass rate during the six-year study period were 463 and 93%, respectively. In unadjusted analyses comparing each year individually, mean PANCE score was highest in 2020 and lowest in 2022 than in all other years except for 2017. When comparing each pandemic year to the pooled three pre-pandemic years and adjusting for test-taker and PA program covariates, examinees scored significantly higher in 2020; there was no difference in 2021, and they scored lower in 2022. When controlling for covariates, examinees had 1.24 higher odds of failing in 2022 compared to the pooled pre-pandemic period. Conclusion Findings suggest that PANCE scores and pass rates were impacted during the third year of the pandemic. PANCE assesses if examinees have the essential clinical knowledge to enter the PA profession. It is crucial to determine whether the pandemic affected PANCE scores and pass rates to ensure PAs provide safe and high-quality patient care.

BackgroundA lifesaving treatment for myocardial infarction is the placement of a stent in a closed or obstructed coronary artery. The largest modifiable risk factor after receiving a stent is medication adherence to Dual AntiPlatelet Therapy, a combination of P2Y12 inhibitors and aspirin. ObjectiveThis study aimed to determine the acceptability of a protocol and an intervention using the My Interventional Drug-Eluting Stent Educational App (MyIDEA) and to evaluate medication adherence using the proportion of days covered (PDC) and platelet activation tests in a multisite randomized controlled trial. MethodsPotential participants who received a post percutaneous coronary intervention (PCI) procedure with a drug-eluting stent were approached. All patients older than 50 years and who spoke English were recruited. Participants were recruited, baseline demographics were collected, and the Hospital Anxiety and Depression Scale (HADS), Rapid Estimate of Adult Literacy in Medicine-Short Form, Burden-Benefit questionnaire, 36-Item Short Form Health Survey, and PCI knowledge questionnaire were administered. Block randomization was used to randomize participants to either usual care or MyIDEA supplementation. MyIDEA is a personalized educational intervention based on the Kolb experiential learning theory using patient narratives for education. During the visits, participants’ blood was collected to measure platelet suppression from medication. During the second and third encounters, the Morisky medication adherence score and cardiology outcomes were measured. The study was conducted at the University of Illinois Hospital and John H Stroger Jr Cook County Hospital with appropriate ethical approvals. Platelet suppression was measured through aspirin reactive units and P2Y12 reactive units. Medication adherence was measured using the PDC. The analysis team was blinded to the participants’ group membership. The primary outcome was a feasibility analysis of recruitment and retention. ResultsThe mean age of participants was 60.4 years (SD 7.1); the majority of patients were black and non-Hispanic. The majority of patients’ reading levels were seventh grade or above, and they were not very familiar with other electronic devices for information and communication. The number of control subjects was 21, and the number of participants in the interventional arm was 24. The interventional group was able to use MyIDEA in both the hospital and outpatient setting. However, there was no significant difference in platelet suppression or medication adherence between groups. There were also differences between the groups in terms of depression and anxiety, initially, as measured by HADS. No documented adverse event associated with the intervention was found. ConclusionsElderly patients are willing to use tablet devices to be educated about health conditions. Additional studies are required to measure the effectiveness and determine the most suitable timing and location for patient education. Trial RegistrationClinicalTrials.gov NCT04439864; https://clinicaltrials.gov/ct2/show/NCT04439864

Background/Aims: This study’s objective was to evaluate a patient-centered educational electronic tablet application, My Interventional Drug-Eluting Stent Educational App (MyIDEA) to see if there was an increase in patient knowledge about dual antiplatelet therapy (DAPT) and medication possession ratio (MPR) compared to treatment as usual. Methods: In a pilot project, 24 elderly (≥50 years-old) research participants were recruited after a Drug Eluting Stent. 11 were randomized to the control arm and 13 to the interventional arm. All participants completed psychological and knowledge questionnaires. Adherence was assessed through MPR, which was calculated at three months for all participants who were scheduled for a second and third follow-up visit.Results: Relative to control, the interventional group had a 10% average increase in MPR. As compared to the interventional group, more patients in the control group had poor adherence (

Purpose: The aim of this research was to compare different methods of calibrating multiple choice question (MCQ) and clinical decision making (CDM) components for the Medical Council of Canada’s Qualifying Examination Part I (MCCQEI) based on item response theory. Methods: Our data consisted of test results from 8,213 first time applicants to MCCQEI in spring and fall 2010 and 2011 test administrations. The data set contained several thousand multiple choice items and several hundred CDM cases. Four dichotomous calibrations were run using BILOG-MG 3.0. All 3 mixed item format (dichotomous MCQ responses and polytomous CDM case scores) calibrations were conducted using PARSCALE 4. Results: The 2-PL model had identical numbers of items with chi-square values at or below a Type I error rate of 0.01 (83/3,499 or 0.02). In all 3 polytomous models, whether the MCQs were either anchored or concurrently run with the CDM cases, results suggest very poor fit. All IRT abilities estimated from dichotomous calibration designs correlated very highly with each other. IRT-based pass-fail rates were extremely similar, not only across calibration designs and methods, but also with regard to the actual reported decision to candidates. The largest difference noted in pass rates was 4.78%, which occurred between the mixed format concurrent 2-PL graded response model (pass rate= 80.43%) and the dichotomous anchored 1-PL calibrations (pass rate= 85.21%). Conclusion: Simpler calibration designs with dichotomized items should be implemented. The dichotomous calibrations provided better fit of the item response matrix than more complex, polytomous calibrations.

BackgroundPatient adherence to medication regimens is critical in most chronic disease treatment plans. This study uses a patient-centered tablet app, “My Interventional Drug-Eluting Stent Educational App (MyIDEA).” This is an educational program designed to improve patient medication adherence. ObjectiveOur goal is to describe the design, methodology, limitations, and results of the MyIDEA tablet app. We created a mobile technology-based patient education app to improve dual antiplatelet therapy adherence in patients who underwent a percutaneous coronary intervention and received a drug-eluting stent. MethodsPatient advisers were involved in the development process of MyIDEA from the initial wireframe to the final launch of the product. The program was restructured and redesigned based on the patient advisers’ suggestions as well as those from multidisciplinary team members. To accommodate those with low health literacy, we modified the language and employed attractive color schemes to improve ease of use. We assumed that the target patient population may have little to no experience with electronic tablets, and therefore, we designed the interface to be as intuitive as possible. ResultsThe MyIDEA app has been successfully deployed to a low-health-literate elderly patient population in the hospital setting. A total of 6 patients have interacted with MyIDEA for an average of 17.6 minutes/session. ConclusionsIncluding patient advisers in the early phases of a mobile patient education development process is critical. A number of changes in text order, language, and color schemes occurred to improve ease of use. The MyIDEA program has been successfully deployed to a low-health-literate elderly patient population. Leveraging patient advisers throughout the development process helps to ensure implementation success.